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Medical City Emergency Room and Health Care Reform

Medical City Dallas
Medical City Dallas
Point of Care

A Dallas Registered Nurse works the Emergency Room at Medical City in Dallas. Last weekend she observed much good care administered. Along with that good care, because an E.R. can’t turn anyone away, there are frequent gamers of the system, who come in with specific, learned-by-rote complaints that cost thousands of dollars to administer tests for and result in dosages of morphine, dilauden, or other meds. They also get a clean, safe place to sleep, good food, TV, and other comforts. Of course the employees are keenly aware of these abuses, even referring internally to these abusers as “Frequent Flyers.” For a 24 hour observation period Frequent Flyers talk, then they walk, they breathe, then they leave, they eat, then they hit the street. Then they go to the next hospital to do it again, and there’s no communication between the hospital to know what’s going on. So hospital administrators aren’t ignorant people, must be aware, and must build it into their business model to expect an ability to submit claims to collect an acceptable percentage to support the abuse, not unlike retailers must deal with inventory shrink and non-pay customers turned over to debt collectors.

Because less than 5% of claims are audited, Fraud is a significant unknown in existing Medicare and Medicaid, and will continue to be in the next iteration of socialized medicine in the new Health Care Bill.

Granted, the bill will be a godsend for folks who can't afford or qualify for health insurance in the short run. And to many this trumps all negatives that come with the new bill.

In the long run Nobel Prize Economists Milton Friedman and Kenneth Arrow make separate cases about the futility of sustaining it. Another one, Paul Krugman, maintains we're already half-way there with socialized medicine (Medicare, Medicaid, other gov subsidies) so we should get all the way in.

Reading the cries of pain from folks who need what the new Health Care claims to achieve is gut wrenching.

Some claim the bill throws resources at a broken system in the auspices that "we must do something." If this becomes a placeholder for a different solution that would be great, but its not designed and its not likely to occur that way.

Give the Democrats credit for doing something to get the ball rolling. They did something while the Republicans did less than nothing while the problems escalated.

What the bill appears to achieve for some to be is a panacea for folks needing insurance to be both insured and made healthy. What it appears to others is gasoline to an uncontrollable forest fire of unmanageable cost during an economic downturn and global turmoil.

What I have observed on both sides of the fence is strong, angry and polarized opinions. I’ve also observed some intelligent discourse on the real issues based on facts. The former achieves nothing in the blogosphere and resentment among pundits. The latter moves minds to change locally and globally.


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